Agencies work together to confront heroin rise in Madison County

WAMPSVILLE — The Madison County Opioid Task Force has combined the expertise of its member agencies to confront the rise in heroin use in the county since its formation in 2015.

Heroin and opioid abuse has caused an increase in arrests, child welfare complaints and hospitalizations in the county in recent years. Bewteen 2010 and 2014, for example, emergency room visits to hospitals in Oneida and Hamilton linked to heroin use has increased by 123 percent.

“We are using the three-pronged approach of prevention, treatment and enforcement through our different departments,” Madison County Department of Social Services Commissioner Michael A. Fitzgerald said.

Fitzgerald and the DSS have been tasked with protecting family health. Petitions involving child abuse or neglect have doubled in Madison County since 2014 because of heroin use. A petition is a request for investigation of child abuse or neglect.

“Last year we had 128 investigations and in all but two of them we managed to keep the children with their families while their parents received treatment,” Fitzgerald said.

Heroin and opioid abuse is becoming more common, and harder to recognize.

“You don’t see obvious signs of the problem, like you often do with alcoholism,” Fitzgerald said. “You could go visit relatives, not suspecting anything, and then find your aunt in the bathroom with a needle in her arm. It’s been a wild ride.”

Gateway to addiction

Madison County Sheriff Allen Riley agrees with Fitzgerald and other experts that the main cause of heroin use is the over-prescription of what are termed gateway drugs. These include prescription pain-killers like oxycontin. Arrest rates in the county reflect this.

In 2010, heroin arrests made up two percent of arrests in Madison County and illegally-held prescription medicine containing opioids were 10 percent. In 2012 heroin arrests were up to 14 percent and opioids at eight percent. Through 2014 and 2015 heroin was at 11 percent and opioid arrests were down to four percent.

“Illegal opioid arrests are down because doctors are prescribing opioid-based medicines less frequently,” Riley said. “There’s been a state law that limits how long a doctor may prescribe these medications. It’s been reduced from 90 days to 30 days. People are now using heroin because it’s easier to find than prescription drugs.”

The overuse of prescription drugs, experts say, remains an ongoing cause of heroin addiction. The insurance company Excellus Blue Cross/Blue Shield stated that in 2015 the average pain medication containing an opioid lasted for 65 doses, or an average of 16 days. Studies suggest a physiological dependence on opioids begins after five to seven days of use.

“This epidemic spans all social and economic barriers,” Fitzgerald said. “An athlete could get hurt and be prescribed painkillers, and then become an addict.”

A way out

A growing number of jails across the country have instituted a Vivitrol program to help inmates suffering from heroin addiction. Vivitrol is given once a month through an injection while naltrexone, the generic drug that Vivitrol is derived from, is given once a day in pill form. One shot of Vivitrol lasts a month, while addicts either forget to take their naltroxene or set it aside and return to heroin use.

Vivitrol reduces temptation through a monthly shot by removing cravings. This handles the physical aspect of addiction, while 12-step and group therapy help handle the mental and emotional aspects.

One criticism of Vivitrol is that it works too well. Addicts may think their issue is under control, when an emotional or environmental trigger outside the structure provided by jail could return an addict to heroin use. Cost is an issue as well: a monthly insurance co-pay for naltrexone is $11 and Vivitrol costs $1,100 per month.

Madison County has one person involved in its nascent Vivitrol program.

“We are in the beginning stage of using Vivitrol, and we aren’t sure how or if it will develop further. We don’t have any kind of support set up for individuals after they’ve been released,” Riley said.

The county has counseling available through its counsel on alcohol and substance, or BRiDGES, program and also peer recovery support at Oneida’s Pathways Wellness Center. BRiDGES may be reached at 315-697-3947 and Pathways may be reached at 855-387-3030.

Riley believes the war on heroin abuse is winnable.

“If we are able to reduce the cause, which is overprescription of opioid-based pain relievers, then I think we can overtake this epidemic,” he said. “We have to learn to adapt. It’s always something - we’ve gone from synthetic drugs to bath salts and now it’s heroin.”